Purpose: Kidney transplantation greatly increases the chance of pregnancy and live birth in women with end stage kidney disease of reproductive age. While maternal outcomes are well documented, foetal outcomes have been less well described.
Methods: Data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry and data from the National Perinatal Statistics Unit's (NPSU) Australia's mothers and babies' report were analyzed. We compared pregnancy outcomes within the transplant population by decade of transplant, maternal age, cause of ESKD, graft source and time since transplantation. We compared neonatal outcomes of stillbirth, neonatal mortality, birth weight and gestational age between transplant mothers and the general population.
Results: There were 692 pregnancies in 447 female transplant recipients reported in ANZDATA between 1971 and 2010, and 5,269,645 pregnancies reported by the NPSU in Australia between 1991 and 2010. At time of pregnancy transplant mothers had a median age of 31 (IQR: 27, 34), a median eGFR of 54 (IQR: 44, 65) and a functioning transplant for a median of 5 (IQR: 3, 9) years. The mean gestational age for all births in transplant recipients was 36 (±5) weeks, significantly shorter than the national average of 39 (±0) (P<0.0001). The mean birth weight of live births to transplant recipients was 856gms (P<0.0001) lower than the national average (2502 ±782gm vs. 3358 ±3gm). However, when gestational age was accounted for there was no significant difference in mean birth weights. There was a higher perinatal mortality rate in babies born to transplant recipients at 6.5% compared to 1.0% nationally (P<0.001).
Conclusion: Babies of transplant mothers were smaller due to earlier delivery and had a shorter gestation than the general population. While the risk of mortality was 6 times greater than the general population the majority of pregnancies were completed successfully by transplant mothers with a number using IVF to achieve pregnancy.
To cite this abstract in AMA style:Wyld M, Clayton P, Chadban S, Alexander S. Foetal Outcomes for Kidney Transplant Recipients [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/foetal-outcomes-for-kidney-transplant-recipients/. Accessed October 29, 2020.
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